Apparently, Thursday’s version of the public option has a provision for states to opt out if they think it will lead to super communism. This is one of those compromises that can only have come about as a solution to a political problem because it sure isn’t a solution to the healthcare problem.

Healthcare is one of those situations in which it is necessary for the federal government to make sure the states are doing the right thing for their citizens. The McCarran-Ferguson Act is currently under review in the Senate Judiciary Committee. The act, which was passed in 1945, essentially gives states the authority to regulate insurance companies without the interference of the federal government. And it hasn’t worked very well. In some states it really, really hasn’t worked very well. In North Dakota, Blue Cross Blue Shield controls about 90% of the market. There aren’t enough people in the state to entice any real competition. If only there were some sort of option that could help introduce competition in North Dakota…

Under those circumstances, it seems likely that North Dakota would choose to offer the public option if it were made available. But what about some other states? In Arkansas, BCBS controls about 75% of the market. Sen. Blanche Lincoln of Arkansas might vote for a public option that states can opt out of. So, does that mean Arkansas would opt out despite its apparently dire need for a public option? What about other southern states where a combination of high poverty rates and poor diet have made people generally unhealthy? Will they reject the public option and make their people suffer just to spite President Obama? Perhaps we’ll see a situation similar to the stimulus package in which the Republican governors go Ahab on runaway spending but then smile pretty when it’s time to hand out giant checks.